DR. JOSEPH KELLY PHD
NPI 1306209150
Psychologist - Clinical in Tustin, CA

Q: What is Joseph Kelly's NPI number?

The NPI number for Joseph Kelly is 1306209150. It was assigned to this individual provider in the NPPES registry on March 30, 2016.

Q: What is Joseph Kelly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Joseph Kelly enrolled in Medicare?

No. Joseph Kelly has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Joseph Kelly was last updated on October 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 30, 2016Opted out of Medicare · through Jul 1, 2028

228 W MAIN ST, TUSTIN, CA 92780(949) 558-4925 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 23, 2018, Dec 5, 2018, Mar 30, 2016 (3 updates tracked since 2016).

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About Dr. Joseph Kelly Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOSEPH KELLY PHD (NPI 1306209150) is an individual clinical provider in Tustin, California, licensed in California (30307) and active in the NPI registry since March 2016. He has opted out of Medicare through July 1, 2028.

NPPES Registry Identity

NPI1306209150

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JOSEPH KELLYCredential: PHD

Location Address228 W MAIN STTustin, CA 92780-4320

Mailing Address228 W Main StTustin, CA 92780-4320 · (916) 715-4741

Phone(949) 558-4925

Sole ProprietorNo

Enumeration DateMarch 30, 2016

Last NPPES UpdateOctober 22, 20253 updates tracked since enumeration

NPPES CertifiedOctober 22, 2025

✔ NPI 1306209150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · 30307

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 30307 (CA)

228 W MAIN ST, Tustin, CA 92780

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Joseph Kelly Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2026

Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD MALLRY KEPPLE LMFT

Marriage & Family Therapist